Medicare Coverage and Reimbursement

Issue Summary

Medicare is a program for those age 65 and over, the disabled and end-stage renal disease patients. Consequently, Medicare beneficiaries make up a fairly small part of the typical midwife's patient population. For example, total Medicare payments to CNMs in 2011 amounted to just over $3 million.

Medicare's real importance to midwifery lies in its position as the steward of various payment methodologies and policy structures that are often adopted by state Medicaid programs and private insurers. Consequently, understanding Medicare is often key to understanding how other coverage and reimbursement systems operate.